Article Date: 2/1/2004

view from the top
Uncovering Inefficiencies
Are you and your staff performing office tasks efficiently?
By Gary Gerber, O.D.

"We don't make money on these things. Quite the contrary. It costs more . . . than we make in revenue . . . ."

Sounds like something you'd overhear when two doctors refer to the latest managed care plan to come across their desks. But this is what Michael Bloomberg, mayor of New York City, said. And he wasn't discussing the optometric woes of managed care. Rather, he was responding to the recent public criticism brought on by a rash of so-called "Quality of Life" tickets, which police officers were handing out in the summer of 2003 for things such as sitting on milk crates or taking up two subway seats.

After being accused of ramping up the issuing of these tickets as a way to combat the city's multi-billion dollar budget deficit, Mayor Bloomberg responded with the above quote. (Sources later reported that the city spent $2.09 for every dollar it collected.)

Take an inward look

Take a look around your own office for things that "cost more than you get in revenue." An exercise I perform when I visit a client's office is to take each part of a process and ask, "Why do you do it this way?" and, "Is there a better, more efficient way to do it?" The number-one answer to the former question, regardless of what "it" is is, "Because that's how we've always done it!"

Of course, that doesn't mean that what's being done is wrong or inefficient, but the way we might run the processes in our offices today is certainly different than how we ran them years -- or even months -- ago! Just consider the straightforward process of ordering a patient's contact lenses.

Consider this

Many of us have a "contact lens order form" or "contact lens order book" that might contain the patient's prescription, date, phone number, address, etc. You or a staff member typically fills in all of this data and orders the lenses. From there, you record an order confirmation number and then transcribe all of this data into the order book.

Now isn't most or all of this information already recorded somewhere else? Surely at the very least you'll find each patient's name, address, phone number and prescription in their optometric record. Yet the above redundant system has us recording this information again and again. Might this lengthy process cost us more than we're actually making from the lenses themselves? Does the Mayor's quote maybe apply to this process?

Why ask why

"Why do you do it this way and is there a better, more efficient way to do it?" is an effective strategy for saving money in your practice. (When working with clients on setting up effective systems and processes, it's at the core of what we do as consultants.) Examine every administrative procedure and task in your office (the list below will help get you started) and keep asking the above "why" question.

This is a rough checklist, but addressing any one of these items will uncover inefficiencies that might cost more money to implement than the revenue it generates.

Just a thought

The Mayor's complete quote was, "We don't make money on these things." He added, "Quite the contrary. It costs more to write the summons than we get in revenue. The purpose is to get people to comply with the law."

So can we give out tickets for noncompliant patients or those who don't understand how costly it is for us to administer their managed care plans? Now that would be a great source of revenue!

Dr. Gerber is the president of the Power Practice, a company specializing in making optometrists more profitable.  Learn more at or call Dr. Gerber at (800) 867-9303.

Optometric Management, Issue: February 2004